Request for Fitness to work certificate (a "sick line")

Request for Fitness to work certificate (a "sick line")

You only need a fit note if you have already had 7 days off work.

We will only provide a fit note AFTER that. (All UK employees have a SATUTORY RIGHT to self-certify for the first 7 days so we will not provide a certificate before that time.)

We may be able to provide a certificate from day 8 onwards. 

Note that this certificate is only ADVISORY to you and to your employer. 

If you decide to return to work earlier than stated on the certificate you DO NOT need a return to work certificate. 

It is the DOCTOR who decides the wording on the form. 

  • Your Details

    This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the nhs. Please read our privacy policy to discover how we protect and manage your submitted data.
    Date of Birth
    For example, 15 3 1984

  • Certificate details

    The date required for the START of THIS certificate (Note : it can be back dated but NOT forward dated)
    For example, 15 3 1984
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Page last reviewed: 13 October 2025
Page created: 10 October 2025